Osteoarthritis

Osteoarthritis?


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Osteoarthritis (OA) is known by various names including degenerative joint disease or degenerative arthritis. It is the most common chronic condition of the joints, especially the knees, hips, lower back and neck, and the small joints of the fingers. As OA progresses, bones break down and forms spurs. Bits of bones or cartilages chip off and float around in the joint. The cartilage wears away and the bones rub against each other leading to joint damage in the final stages of OA. OA occurs in people of all ages though it is mostly observed in elderly people.

Patho-Physiology

  • OA is primarily occurs due to damage to cartiage Occurrence of OA is still unknown.
  • Interieukin -1 (IL-1) a pro-inflammatory cytokine induce chondrocyte and synovial cells to synthesize MMPs.
  • These MMP are the primary enzymes in the degradation of articular cartilage.
  • Also, IL-1 suppress the synthesis of type II collagen and proteoglycans and inhibits the transforming growth factor-8 stimulated chondrocyte proliferation.
  • This leads to the degeneration of articular cartilage and I reading to Osteoarthritis.

What are the Symptoms of OA
There is a wide range of symptoms, which depend on the severity of the disease. Common symptoms include pain and stiffness early in the morning or after stillness, limited range of motion, cracking sound of joints in movement, mild swelling around a joint, loss of flexibility, and unbearable pain. OA affects the hips, knees, feet and fingers. OA symptoms hinder work, family life, and social life if not cared for.

OA leads to a lot of other conditions such as diabetes, cardiovascular disease, and dizzy walks leading to falls.

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What are the Causes of OA
OA was believed to be caused by the wear and tear of joints, but some other factors that lead to OA are listed below:

Genes: Defective genes when inherited results in slight defects in the way the bones fit together, thus leading to faster wear and tear of the cartilage. The FAAH gene is found in abundance in people with OA when compared to normal individuals. Various other genetic traits, such as a rare defect in the body’s production of collagen that makes up the cartilage, also make a person fall prey to OA.

Obesity: The hip and knees are the two major focus areas that are burdened due to over-weight. Carrying extra kilos for long years leads to the breakdown of the cartilages. Further, excess fat tissue leads to the production of inflammatory chemicals that damage the joints.

Injury and overuse of joints: Repetitive injuries to joints also lead to OA. Occupation is one of the causative agents for OA. Standing for long periods of time, repetitive bending, lifting of heavy objects actions that lead to cartilage wear and tear.

Disorders like rheumatoid arthritis and metabolic disorders such as hemochromatosis also are causative agents to OA.

How is OA Diagnosed
Diagnosis of OA involves the collection of personal information, family medical history, and performing a physical examination to check the joints and test their range of motion. Areas that are tender, painful, or swollen are focused. The position and alignment of the neck and spine is also studied in case of OA diagnosis.

Further certain tests are performed to confirm OA. They are:

  • Joint aspiration: Fluid from the affected area is taken using a needle and is examined. The presence of crystals or joint deterioration is indicative of OA.
  • X-rays show damage and other changes related to OA.
  • MRI

How is OA treated?
OA is a long-tern condition and it has no cure till date. Various therapy options are available only to manage the symptoms, such as pain, stiffness, and swelling, and improving joint mobility and flexibility.

Exercising or physical activities is hard to think about when you have OA. But the joints need to be in movement. A small walk or doing simple exercises are the feasible options that one may think of.

Muscle strengthening exercises ease the burden on the affected joints, thereby reducing the pain. Aerobics helps to improve stamina and reduce weight. Losing weight helps reduce pain and limit further joint damage.

Though OA cannot be cured to the fullest extent, pain and anti-inflammatory medications are available to reduce the symptoms.

OA and stem cell therapy

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Stem cells help in the regeneration of cartilages that are worn out in OA. Mesenchymal stem cells differentiate into cartilages called chondrocytes. Stem cell therapy is found to have healing effect in cases with OA. Various studies showed that administration of mesenchymal stem cells from various sources like adipose tissue, umbilical cord tissue-derived and bone marrow showed significant improvement in OA patients. They not only differentiate into chondrocyte, they also induce osteocyte and other chemokines to act on the damaged knee to reinstate to normal state. Combination of PRP and MSC could mutually help in augment the healing of osteoarthritis.